Total abstention from food and water from sunrise to sunset during the month of Ramadan, is practiced by hundreds of millions of Muslims throughout the world. This pattern of fasting during Ramadan is different from the usual fasting as people are allowed to eat and drink between sunset and dawn but not after dawn. The amount and type of food (rich in protein, fat and sugar) eaten during the night may also be significantly different to that usually consumed during the rest of the year, while in other countries factors such as poverty ensure that the Ramadan fast results in a reduction in energy intake and a loss of body fat. Also, climate and duration of fasting differs from region to another. According to Islam, sick people are exempted from Fasting, but still a significant number of patients with various chronic diseases including chronic kidney diseases (CKD)insist on fasting in Ramadan due to their personal beliefs and physicians are facing this problem every year: What to advice their patients as there are no guidelines or protocols about who can and who cannot fast. In general no detrimental effects on health have been directly attributed to fasting during Ramadan. However caution is advised for moderate to severe CKD patients and the physicians should monitor their patients carefully during Ramadan in order to avoid any deleterious effects.